Remote surgery support system

ABSTRACT

A first signal transmission apparatus installed in an operating room and a second signal transmission apparatus installed in a remote control room in a remote place are linked by a public line. Assuming that surgery is performed on a patient using a surgical instrument in the operating room while endoscopic images are viewed, the surgical instrument can be controlled using a first controller. The contents of control and patient data are displayed on a display device via a second controller connected to the second signal transmission apparatus. The state of the surgical instrument and the patient data can always be checked in the remote control room. Surgical instructions or any other surgical support can be given easily.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This is a divisional of U.S. patent application Ser. No.09/503,520, filed Feb. 14, 2000 in the name of Akinobu UCHIKUBO andentitled REMOTE SURGERY SUPPORT SYSTEM.

BACKGROUND OF THE INVENTION

[0002] 1. Field of the Invention

[0003] The present invention relates to a remote surgery support systemfor remotely supporting surgery.

[0004] 2. Description of the Related Art

[0005] Normally, a surgeon performs surgery on a patient in an operatingroom. Sometimes the surgeon may have to carry out a surgical procedurewith which the surgeon has little experience. A support system forhelping the surgeon appropriately perform surgery on a patient ispresumably such that the surgeon in the operating room can performsurgery while being supported by a remotely supporting surgeon.Specifically, the surgeon in the operating room communicates with theremotely supporting surgeon in a remote place over a public line duringsurgery.

[0006] Related arts concerning the remote surgery support system forremotely supporting surgery include Japanese Patent Application No.10-318019.

[0007] According to the related art, when surgery is performed bycontrolling the movement of a surgical instrument using a manipulator, asurgeon in an operating room is informed of the manipulation expressedby a manipulation signal produced when a remotely supporting surgeoncontrols the surgical instrument. Consequently, the surgeon in theoperating room can smoothly carry out a surgical procedure with the helpof the remotely supporting surgeon.

[0008] However, according to the related art, the remotely supportingsurgeon cannot monitor the state of the surgical instrument in theoperating room. For instructing the way of manipulating the surgicalinstrument from a remote control room to the operating room, theremotely supporting surgeon must ask verbally as to the state of thesurgical instrument from time to time. A surgical procedure is thereforesuspended frequently. Consequently, there is an increasing demand for anenvironment in which surgery can be performed more smoothly.

[0009] Moreover, the remotely supporting surgeon has no means forchecking patient data. Patient information must therefore be sent to theremotely supporting surgeon. In case of emergency surgery, it isimpossible to make patient information timely available in a remoteplace.

SUMMARY OF THE INVENTION

[0010] An object of the present invention is to provide a remote surgerysupport system making it possible to readily check the state of asurgical instrument and/of patient information in a remote place over acommunication line.

[0011] Another object of the present invention is to provide a remotesurgery support system making it possible to give instructions onsurgery while readily checking the state of a surgical instrument and/orpatient information in a remote place over a communication line.

[0012] Still another object of the present invention is to provide asurgical information display method making it possible to observeendoscopic images and readily check the state of a surgical instrumentand/or patient information.

[0013] A remote surgery support system consists mainly of:

[0014] a first control means installed in an operating room forcontrolling a surgical instrument;

[0015] an input means for use in inputting control information, withwhich the surgical instrument is controlled, to the first control means;

[0016] a first signal transmission apparatus for receiving information,which indicates the controlled state of the surgical instrument, fromthe first control means, and converting the information into atransmissible signal;

[0017] a communication line over which the transmissible signalconverted by the first signal transmission apparatus to a control roomin a remote place;

[0018] a second signal transmission apparatus for receiving thetransmissible signal from the first signal transmission apparatus overthe communication line, and converting the signal into a signalcorresponding to the information;

[0019] a second control means for receiving the signal from the secondsignal transmission apparatus; and

[0020] a display device for displaying an output of the second controlmeans.

[0021] Consequently, surgeon staying in the remote place can monitor thestate of the surgical instrument.

[0022] The remote surgery support system further includes:

[0023] a second input means for supplying support information to thesecond control means; and

[0024] a second display device for inputting the support informationfrom the second control means via the second signal transmissionapparatus and the first signal transmission apparatus, and displayingthe information.

[0025] Consequently, the surgeon in the remote place can input supportinformation concerning a procedure at the second input means to thesecond control means. The input support information is displayed on thesecond display device via the second signal transmission apparatus andthe first signal transmission apparatus. The surgeon in the operatingroom can carry out the procedure.

BRIEF DESCRIPTION OF THE DRAWINGS

[0026] The invention is described in detail below with reference to thefollowing figures in which similar reference characters denotecorresponding features consistently throughout, wherein:

[0027]FIG. 1 to FIG. 6 relate to the first embodiment of the presentinvention;

[0028]FIG. 1 is a schematic view of a remote surgery support system inaccordance with the first embodiment;

[0029]FIG. 2 is a schematic view of the remote surgery support systemshown in FIG. 1;

[0030]FIG. 3 is a schematic view of a controller in a surgery system;

[0031]FIG. 4 is a schematic view of a second controller in a remotesupport system;

[0032]FIG. 5 is a display view of a display screen of a display device;

[0033]FIG. 6 is a flowchart of a sequence of information displayinvolving the surgery system and remote support system;

[0034]FIG. 7 is a schematic view of a remote surgery support system inaccordance with the second embodiment of the present invention;

[0035]FIG. 8 is a display view of a display screen of a display devicein accordance with the third embodiment of the present invention;

[0036]FIG. 9 and FIG. 10 relate to the fourth embodiment of the presentinvention;

[0037]FIG. 9 is a schematic view of a remote surgery support system inaccordance with the fourth embodiment;

[0038]FIG. 10 is a schematic view of the remote surgery support systemshown in FIG. 9;

[0039]FIG. 11 is a schematic view of a remote surgery support system inaccordance with the fifth embodiment of the present invention;

[0040]FIG. 12 is a schematic view of a remote surgery support system inaccordance with the sixth embodiment of the present invention;

[0041]FIG. 13 is a schematic view of a remote surgery support system inaccordance with the seventh embodiment of the present invention;

[0042]FIG. 14 to FIG. 18 relate to the eighth embodiment of the presentinvention;

[0043]FIG. 14 is a schematic view of a medical information processingsystem;

[0044]FIG. 15 is a schematic view of an information accumulation system;

[0045]FIG. 16 is a schematic view of a control circuit;

[0046]FIG. 17 is a display view of a medical information display screen;

[0047]FIG. 18 is a print out view of a clinical recording printout;

[0048]FIG. 19 to FIG. 22 relate to the ninth embodiment of the presentinvention;

[0049]FIG. 19 is a schematic view of a medical information processingsystem;

[0050]FIG. 20 is a schematic view of a control apparatus for producingclinical recordings;

[0051]FIG. 21 is a display view of a displayed integrated informationscreen; and

[0052]FIG. 22 is a printout view of the a printed clinical recording.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0053] Referring to the drawings, embodiments of the present inventionwill be sequentially described below. To begin with, the firstembodiment will be described with reference to FIG. 1 to FIG. 6.

[0054] The present embodiment is a remote surgery support system. Anoperating room and a remote control room in a remote place are likedwith a communication line. A surgeon in the operating room receivessupport information from the remote control room and performs surgery.

[0055] As shown in FIG. 1 or FIG. 2, a remote surgery support system 1in accordance with the first embodiment of the present invention has asurgery system 2 connected to a remote support system 3. The supportsystem 3 is connected remotely to the surgery system 2, over a publicline 4. The surgery system 2 and remote support system 3 are installedin an operating room 5 and a remote control room on remote supportsystem room 6, respectively.

[0056] The surgery system 2 installed in the operating room 5 has anendoscopic imaging apparatus 10 and a surgical apparatus or surgicalinstrument 20. The endoscopic imaging apparatus 10 is used to observe anintracavitary region of a patient 7. The surgical apparatus or surgicalinstrument 20 is used to perform surgery on the patient 7 for curing alesion under observation through the endoscopic imaging apparatus 10.

[0057] To be more specific, as shown in FIG. 2, a surgical instrumentbody 8 and an optical endoscope 9 are advanced into, for example, theabdominal cavity of the patient 7. The surgical instrument body 8 isused to perform surgery for curing a lesion. The optical endoscope 9 isused to observe the progress of surgery performed using the surgicalinstrument body 8.

[0058] The surgical instrument body 8 is an instrument for incising orcoagulating a lesion using, for example, electric cautery. The surgicalinstrument body 8 is connected to a power supply unit 11. The powersupply unit 11 supplies driving power to the surgical instrument body 8over a cord or the like. The power supply unit 11 has the ability topermit variance of the setting of an output value or an output waveformof electric energy according to whether an incision mode or acoagulation mode is selected. The surgical instrument body 8 and thepower supply unit 11, or control unit in some instruments, constitutethe surgical instrument 20.

[0059] The endoscope 9 is, for example, a rigid endoscope having a rigidinsertion unit 12. A TV camera 15, having, for example, a charge coupledevice (CCD) 14 as an imaging device incorporated therein, is mounted onan eyepiece unit 13 located at the back end of the insertion unit 12,whereby a means for producing endoscopic images is realized.

[0060] A light guide cable 16 extending from the endoscope 9 is linkedto a light source apparatus 17. Light emanating from a lamp (not shown)in the light source apparatus 17 is propagated over a light guidecontained in the light guide cable 16 and a light guide through theendoscope 9. The light is emitted through the end surfaces of the lightguides fixed in an illumination window formed at the distal end of theinsertion unit 12. An object, such as an intracavitary organ, is thusilluminated.

[0061] An objective lens (not shown) is fixed in an observation windowadjoining the illumination window, and forms an optical image of anobject. The optical image is propagated backwardly along, for example, asystem of relay lenses serving as an optical image propagating meanslocated in the insertion unit 12. The optical image can be viewed inenlarged proportions through an eyepiece (not shown) in the eyepieceunit 13.

[0062] The propagated optical image is projected on the CCD 14 via animage formation lens 18 in the TV camera 15. The TV camera 15 is mountedon the eyepiece unit 13 so that it can be dismounted freely. The CCD 14is connected to a camera control unit (hereinafter CCU) over a signalcable 19. A signal photoelectrically converted by the CCD 14 isprocessed by a video processing circuit 21 a in the CCU 21. The videoprocessing circuit 21 a produces and outputs a standard video signal toa first monitor 22 via a mixer 21 b.

[0063] The video signal sent from the CCU 14 is output to the firstmonitor 22. An endoscopic image representing the intracavitary organprojected on the CCD 14 and the distal part of the surgical instrumentbody 8 used for surgery is displayed.

[0064] The CCU 21 and power supply unit 11 are connected to a firstcontroller 24 for controlling the CCU 21 and the power supply unit 11.

[0065]FIG. 3 shows the configuration of the controller 24. Thecontroller 24 consists mainly of a central processing unit (CPU) 35, ahard disk drive (HDD) 36, a memory 37, and an input/output (I/O)interface 38 a. The CPU 35 controls the controller 24. The HDD 36 isused to store operation programs according to which the CPU 35 operates.The memory 37 is used to temporarily store an image and as a work area.The I/O interface 38 a allows input or output of control signals or thelike via a signal transmission unit 27. The CPU 35, HDD 36, memory 37,and I/O interface 38 a are interconnected over a bus 39.

[0066] A touch panel 25 used to input instructions, a magnetic cardreader 26 for inputting patient data or the like, and a keyboard 29 areinterconnected over the bus 39 via interfaces 25 a, 26 a, and 29 arespectively.

[0067] Interfaces 38 b and 38 c output control signals and patient datato the video processing circuit 21 a and mixer 21 b in the CCU 21. Aninterface 38 d outputs the control signals to the power supply unit 11in the treatment instrument 20.

[0068] Assuming that a command or the like is input for changing thetone of endoscopic images using, for example, the touch panel 25, acontrol signal used to change the tone is output from the controller 24to a tone setting circuit in the video processing circuit 21 a in theCCU 21. Tone change is thus controlled. The power supply unit 11 in thesurgical instrument 20 is controlled in order to control output ofelectric energy to the surgical instrument body 8.

[0069] When the surgical instrument body 8 is, for example, an electriccautery instrument, setting of the output level of electrical energy tobe supplied to the instrument body 8 for incision or coagulation can becontrolled remotely with application of a control signal to the powersupply unit 11. When the treatment instrument 20 is a pneumoperitoneumunit, a set value of pressure can be varied.

[0070] The magnetic card reader 26 is used to read patient data recordedon a magnetic card. The patient data is input to the controller 24, andoutput to the mixer 21 b in the CCU 21 via the controller 24. Thepatient data can thus be superimposed on an endoscopic image.

[0071] The CCU 21 and the controller 24 installed in the operating room5 are connected to the first signal transmission apparatus or signalconversion apparatus 27. A video signal expressing endoscopic images isoutput from the CCU 21 to the first monitor 22. The video signal isconverted into a signal, which is transmissible over the public line 4,such as an integrated services digital network (ISDN), using the signaltransmission apparatus 27. The resultant signal is then transmitted to asecond signal transmission apparatus or signal conversion apparatus 28in the remote control room 6 over the public line 4.

[0072] A control signal sent from the controller 24 or patient data isconverted into a signal, which is transmissible over the public line 4,using the signal transmission apparatus 27. The resultant signal is thentransmitted to the signal transmission apparatus 28 in the remotecontrol room 6 over the public line 4.

[0073] A signal sent from the signal transmission apparatus 28 in theremote control room 6 to the signal transmission apparatus 27 over thepublic line 4 is converted or demodulated into a video signalcorresponding to a signal that has not been converted by the signaltransmission apparatus 28. The resultant signal is then output to thesecond monitor 29 connected to the signal transmission apparatus 27.Consequently, image information sent from the signal transmissionapparatus 28 can be displayed on the second monitor 29.

[0074] The signal transmission apparatuses 27 and 28 convert an inputsignal into a transmissible signal, and place the transmissible signalon the public line 4. The signal transmission apparatuses 27 and 28 havethe ability to convert or demodulate) an input signal, which has beentransmitted over the public line 4, into a signal corresponding to asignal that has not been converted or modulated. In short, the signaltransmission apparatuses 27 and 28 provide interface means permittingbidirectional communication over the public line 4.

[0075] The keyboard 29 used to input character data or the like isconnected to the controller 24. using the keyboard 29, character datacan be transmitted to a remotely supporting surgeon or the signaltransmission apparatus 28 via the controller 24.

[0076] The remote support system 3 in the remote control room 6 has athird monitor 31 connected to the signal transmission apparatus 28.Endoscopic images sent from, for example, the CCU 21 in the operatingroom 5 are displayed on the third monitor 31.

[0077] The signal transmission apparatus 28 is connected to a secondcontroller 32. A display device 33 serving as a fourth monitor isconnected to the controller 32. An input means used to enter supportinformation, for example, a touch panel or a keyboard 34, is connectedto the controller 32. A pointing device (not shown), such as a mouse, isalso connected to the controller 32.

[0078] The controller 32 captures an endoscopic image, which is sentfrom the CCU 21 in the operating room 5 via the signal transmissionapparatuses 27 and 28, as a still image. Patient information sent fromthe first controller 24 via the signal transmission apparatuses 27 and28 is input to the controller 32. The controller 32 superimposes thepatient information on the endoscopic image and displays the resultantendoscopic image on the display device 33. The keyboard 34 or any otherinput means is used to enter an indication, for example, a markindicating a position to be resected or the position of an artery towhich attention must be given during resection. The indication isdisplayed as an overlay on the display device 33. This is intended toprovide a surgeon in the operating room 5 with support information suchas instruction information needed for surgery.

[0079] Image information or the like to be displayed as an overlay onthe display device 33 is transmitted to the second monitor 29 in theoperating room 5 via the signal transmission apparatuses 28 and 27. Thecontents of the image information are then displayed on the displayscreen of the second monitor 29. A surgeon in the operating room 5performs surgery while viewing the image that is displayed on the secondmonitor 29 and that has the support information entered by the remotelysupporting surgeon overlaid. Thus, surgery can be performed properly.

[0080]FIG. 4 shows the configuration of the controller 32. Thecontroller 32 consists mainly of a central processing unit (CPU) 40, ahard disk drive (HDD) 41, a memory 42, an input/output (I/O) interface43′ a video capture control unit 44, and a keyboard interface 45. TheCPU 40 controls the controller 32. The HDD 41 is used to store operationprograms according to which the CPU 40 operates, and images. The memory42 is used to temporarily store an image and as a work area. The I/Ointerface 43 permits input or output of control signals or the like viathe signal transmission apparatus 28. The video capture control unit 44captures a video signal and performs superimposition. The keyboardinterface 45 is connected to, for example, the keyboard 34. The CPU 40,HDD 41, memory 42, I/O interface 43, capture control unit 44, andkeyboard interface 45 are interconnected over a bus 49 a.

[0081] Communication of a control signal or the like sent from thesecond signal transmission apparatus 28 is achieved via the I/Ointerface 43. The operation programs according to which the controller32 operates are stored in the HDD 41. For example, controlling themovement of the surgical instrument 20 is established at the touch panel25 in the operating room 5 via the first controller 24. The contents ofthe control are stored in the memory 42 through the I/O interface 43 inthe controller 32 via the signal transmission apparatuses 27 and 28.Patient information is stored in the memory 43 through the I/O interface43 in the controller 32.

[0082] The video capture control unit 44 is connected to the signaltransmission apparatus 28. The video capture control unit has an A/Dconverter 46 for digitizing an input video signal and a D/A converter 47for converting the video signal into an analog form and outputting theanalog video signal.

[0083] The A/D converter 46 and D/A converter 47 are connected to anoverlay control unit 48 for controlling an overlay. The overlay controlunit 48 has a video memory 48 a in which endoscopic image data or thelike are stored. A video signal converted by the A/D converter 46 isstored in the video memory 48 a. Otherwise, a video signal stored in thevideo memory 48 a is output to the display device 33 via the D/Aconverter 47, and then output to the signal transmission apparatus 28.

[0084] The video capture control unit 44 is connected to a controlcircuit 49 for controlling display of an overlay and transmitting orreceiving data. The control circuit 49 is connected to a bus 49 a.

[0085] According to the present embodiment, communication of images bythe signal transmission apparatus 28 is achieved via the A/D converter46 and D/A converter 47 constituting the video capture control unit 44.A video signal input from the A/D converter 46 is converted into imagedata by the overlay control unit 48 under the control of the controlcircuit 49.

[0086] An output of the overlay control unit 48 is transmitted to thesignal transmission apparatus 28 via the D/A converter 47. The CPU 40controls communication of the signal transmission apparatus 28 with thecontroller 32 according to a program stored in the HDD 41.

[0087] An image captured using the video capture control unit 44 can bestored in the HDD 41. An image stored in the HDD 41 is selectedaccording to an entry made by pressing keys of the keyboard 34 forselecting an image. The CPU 40 outputs a reduced image or thumbnailimage of the selected image to the video capture control unit 44. Thereduced image signal may be superimposed on a video signal sent from thefirst signal transmission apparatus 27 using the overlay control unit48.

[0088] Images sent from the signal transmission apparatus 28 areconverted by the A/D converter 46, and captured by the video capturecontrol unit 44. The image as well as control signals and patient datainput via the I/O interface 43 and control circuit 49 can be written inany area in a video memory 48 a in the overlay control unit 48.

[0089] A video signal transferred from the D/A converter 47 is alsooutput to the display device 33. The display device 33 can displayimages like the ones shown in FIG. 5.

[0090] A display area 33 a on the display device 33 consists of a screendisplay area 50, a thumbnail display area 51, a state-of-surgicalinstrument display area 52, a patient information display area 53, and acomment display area 54.

[0091] The thumbnail display area 51 is an area in which a plurality ofimages relevant to a selected item is displayed. For selecting a desireditem, such as patient name, procedure name, or the like, an imageselection button (not shown) appearing on a tool bar displayed in thedisplay area 33 a is manipulated in order to open an image window.

[0092] Displayed in the screen display area 50 are images carried by avideo signal sent from the CCU 21 forming an endoscopic imaging meansand an image selected from the thumbnail display area 51.

[0093] Displayed in the thumbnail display area 51 are reduced images ofimage data accumulated in the second controller 32, and a reduced image(thumbnail image) of a still image produced using a video signal thatexpresses a motion picture or endoscopic images and that is sent fromthe CCU 21.

[0094] Displayed in the state-of-surgical instrument display area 52 arethe states of the surgical instrument body 8 and CCU 21 transmitted fromthe first controller 24.

[0095] Displayed in the patient information display area 53 is patientinformation sent from the first controller 24.

[0096] A comment transmitted from the surgery system 2 is displayed inthe comment display area 54 interposed between the state-of-surgicalinstrument display area 52 and patient information display area 53 shownin FIG. 5.

[0097] The standard H320 and others have been established as a standardfor transmitting images, voice, or data over a public line. The standardH320 may be regarded as a standard stipulating transmission of images,voice, or signals over the ISDn.

[0098] Operations to be undertaken by the present embodiment having theforegoing components will be described below. As shown in FIG. 1 or FIG.2, the surgery system 2 and remote support system 3 are linked by thepublic line 4, such as the ISDN. The power supplies of the surgerysystem 2 and remote support system 3 are then turned on.

[0099] Patient information, including the name of the patient 7, isinput from the magnetic card reader 26 to the first controller 24.

[0100] The endoscope 9 is connected to the light source apparatus 17over the light guide cable 16 so that light can be supplied through theendoscope 9. The TV camera 15 is mounted on the eyepiece unit 13 of theendoscope 9. The signal cable 19 extending from the TV camera 15 islinked to the CCU 21, so that an endoscopic image projected on the CCD14 can be displayed on the first monitor 22.

[0101] A pneumoperitoneum unit is advanced into the abdominal cavity ofthe patient 7 by way of a trocar and cannula (not shown) whereby air issupplied to the abdominal cavity. A flow rate at which air is suppliedto the abdominal cavity is entered at the keyboard 29 or the like.

[0102] The insertion unit 12 of the endoscope 9 is advanced by way ofthe trocar and cannula, so that an image of a lesion in the abdominalcavity can be displayed on the first monitor 22.

[0103] The surgical instrument body 8, such as an electric cauteryinstrument used for surgery, is advanced into the abdominal cavity ofthe patient 7 by way of the trocar and cannula. The output value ofelectrical energy to be supplied to the electric cautery instrument forincision or coagulation is entered at the keyboard 29 or the like. Thecontents of control to be given for surgery are thus entered.

[0104] For changing the tone of endoscopic images displayed on the firstmonitor 22, a control signal is sent from the first controller 24 to theCCU 21 by manipulating the touch panel 25. Thus, the tone can bechanged.

[0105] A video signal output from the CCU 21 to the first monitor 22 andcarrying endoscopic images is transmitted from the first signaltransmission apparatus 27 to the second signal transmission apparatus 28over the public line 4, and then displayed on the third monitor 31.

[0106] The video signal can be input to the second controller 32. Whenan endoscopic image displayed on the third monitor 31 properlyrepresents a region to be resected during surgery, the remotelysupporting surgeon gives instructions at the keyboard 34. The endoscopicimage, a still image, is then captured using the video capture controlunit 44 in the controller 32. The captured endoscopic image is, as shownin FIG. 5, then displayed in the screen display area 50 on the displaydevice 33 connected to the controller 32.

[0107] Patient information read by the magnetic card reader 26 is inputfrom the first controller 24 to the controller 32 through the I/Ointerface 43 via the signal transmission apparatuses 27 and 28. Thepatient information is stored in, for example, the memory 42 in thecontroller 32, and, as shown in FIG. 5, displayed in the patientinformation display area 53 on the display device 33 all the time.

[0108] The remotely supporting surgeon displays the endoscopic imagesent from the operating room 5 with the patient information overlaid.When the surgical instrument body 8 is used to resect a lesion, theposition of a region to be resected is marked on a still image. A mouseor the keyboard 34 (not shown) is used to enter a mark on the stillimage. If attention must be given to an artery located near the regionto be resected, the artery is marked in a color different from the colorof the mark indicating the position of the region to be resected.Support information is thus displayed.

[0109] When an electric cautery instrument is used to incise orcoagulate a lesion, the surgeon in the operating room 5 enters the setvalue of electric energy at the touch panel 25. The contents of controlincluding the setting of electric energy output to the surgicalinstrument 20 are sent from the first controller 24 to the I/O interface43 of the second controller 32, and stored in, for example, the memory42. Control information or setting information concerning the surgicalinstrument 20 is, as shown in FIG. 5, displayed in the state-of-surgicalinstrument display area 52.

[0110] Referring to FIG. 5, setting information of a pneumoperitoneumunit is also displayed in the state-of-surgical instrument display area52. Thus, control information concerning a plurality of surgicalinstruments can be displayed.

[0111] When the surgeon in the operating room 5 changes the output valueof electric energy supplied to an electric cautery at the touch panel25, the changed contents are sent to the I/O interface 43 in the secondcontroller 32 and displayed in the state-of-surgical instrument displayarea 52. The contents of control or setting given to the surgicalinstrument 20 are displayed on the display device nearly in real time.The remotely supporting surgeon can check the state of the surgicalinstrument 20 nearly in real time.

[0112] When the surgeon in the operating room 5 has a comment about thesurgery, the surgeon enters the comment at the keyboard or the like. Thecomment is, as shown in FIG. 5, displayed in the comment display area54.

[0113] When a reply to the comment is requested by the remotelysupporting surgeon, a reply is sent to the operating room 5. The surgeonin the operating room 5 can acknowledge the reply by looking at thesecond monitor 29.

[0114] The remotely supporting surgeon can record an endoscopic imagecaptured by the video capture control unit 44. When a recordinginstruction is given at the keyboard 34, a still image is recorded inthe HDD 41.

[0115] Selected reduced images made by reducing in size any ofendoscopic images accumulated in the HOD 41 can be displayed in thethumbnail display area 51 shown in FIG. 5.

[0116] In addition to the endoscopic images, radiographic images of thepatient 7 can be transmitted from the first controller 24 to the secondcontroller 32 in the remote control room 6. Reduced images of any ofradiographic images accumulated in the HOD 41 can be displayed.

[0117] For performing surgery on the patient 7, the remotely supportingsurgeon can make proper diagnosis by referencing the images on thedisplay device 33. The remotely supporting surgeon can provide theoperating room 5 with support information helpful in the surgeryaccording to the diagnosis.

[0118] Image information displayed as an overlay on the display device33 is displayed on the second monitor 29 via the signal transmissionapparatuses 28 and 27. The surgeon in the operating room 5 carries out asurgical procedure with reference to the contents of the display on thesecond monitor 29 including the support information. The surgeon in theoperating room S can thus accomplish the surgical procedure properly.

[0119] According to the present embodiment, as described in theflowchart of FIG. 6, surgical information acquired in the operating room5 can be displayed in the remote control room 6.

[0120] Specifically, the power supplies of the systems 2 and 3 areturned on. At step S1, patient data of the patient 7 undergoing surgeryand control information used to control the surgical instrument 20 areinput to the controller 24. At step S2, endoscopic images having thepatient data superimposed thereon are displayed on the first monitor 22.

[0121] At step S3, the endoscopic images having the patient datasuperimposed thereon are transmitted from the CCU 24 to the signaltransmission apparatus 28 in the remote control room 6 via the signaltransmission apparatus 27 over the public line 4. The patient data andcontrol information input to the controller 24 are transmitted to thesignal transmission apparatus 28 in the remote control room 6 via thesignal transmission apparatus 27 over the public line 4.

[0122] At step S4, the endoscopic images having the patient datasuperimposed thereon are displayed on the third monitor 31. Theendoscopic images, patient data, and control signal are input to thecontroller 32.

[0123] The keyboard 34 is used to initiate capture of a still image. Astill image of any of the endoscopic images input to the controller 32is obtained by the video capture control unit 44, and displayed on thedisplay device 33, as shown in FIG. 5 (step S6).

[0124] The patient data and the contents of control given to thesurgical instrument 20 are displayed on the display device at the sametime.

[0125] At step S7 if the controller 32 determines whether data has beeninput, if the remotely supporting surgeon enters support data at thekeyboard 34 or the like, the data is overlaid (step S8). Thedata-overlaid image displayed on the display device 33 is transmitted tothe operating room 5 (step S9), and then displayed on the second monitor29 (step S10).

[0126] According to the present embodiment, the remotely supportingsurgeon can view images showing a surgical scene nearly in real time onthe third monitor 31. By looking at the display device 33, the remotelysupporting surgeon can check the state of the surgical instrument 20 inthe operating room 5 nearly in real time at any time, and also checkpatient information. For ordinary and emergency surgery, the remotelysupporting surgeon can ascertain the state of the surgical instrument 20and the patient information at any time. The remotely supporting surgeoncan therefore quickly provide the surgeon in the operating room 5 withsupport information helpful in carrying out a proper surgical procedure.The surgeon in the operating room 5 can reference the supportinformation and carry out a surgical procedure smoothly and quicklyhowever complicated the surgical procedure is.

[0127] The optical endoscope 9 is not limited to a system of relaylenses to propagate an optical image. An optical endoscope adopting animage guide in which a fiber bundle is used to propagate an opticalimage may be used. The surgeon in the operating room 5 and the remotelysupporting surgeon in the remote control room 6 can reciprocallytransfer a voice signal.

[0128] The second embodiment of the present invention will be describedwith reference to FIG. 7. Compared with the first embodiment, thepresent embodiment adopts an electronic endoscope 62 with a built-inimaging device instead of the optical endoscope 9 and TV camera 15 ofthe endoscopic imaging apparatus 10 in the surgery system 2.

[0129] The electronic endoscope 62 has an insertion unit 63, anoperation unit 64 formed at the back end of the insertion unit 63, and auniversal cord 65 extending from the operation unit 64. A connector 66attached to the end of the universal cord 65 is plugged into the lightsource apparatus 17, whereby light is supplied from the light sourceapparatus 17.

[0130] An imaging device (not shown) is incorporated in the distal partof the insertion unit 63. The imaging device is connected to the CCU 21over a signal line 67 linked to the connector 66.

[0131] A video signal output to the second monitor 29 is also input toan image recording apparatus 69. When a recording instruction is inputto the controller 24 using the touch panel 25, an image desired to berecorded can be recorded.

[0132] In the operating room 5, information, including the supportinformation given by the remotely supporting surgeon during surgery, maybe referenced as material for cure after surgery or utilized assignificant material for future surgery.

[0133] According to the present embodiment, a local area network (LAN)70 is adopted as a communication line linking the surgery system 2 andthe remote support system 3 employed in the first embodiment in place ofthe public line 4. The other components are identical to those of thefirst embodiment. Operations to be executed by the present embodimentare nearly identical to those by the first embodiment.

[0134] When a remotely supporting surgeon needs radiographic images orthe like in addition to endoscopic images so as to evaluate a patient'scondition, the image information may be transferred from the controller24 in the operating room 5 to the controller (HDD 41 therein) in theremote control room 6.

[0135] The third embodiment of the present invention will be describedwith reference to FIG. 8. Compared with the endoscope system 1 of thefirst embodiment, a system of the present embodiment does not have thethird monitor 31 installed in the remote control room 6 but uses thedisplay device 33 to display the contents of display on the thirdmonitor 31.

[0136]FIG. 8 shows a practical example of the contents of a display onthe display screen 33 a of the display device 33 in the presentembodiment.

[0137] As shown in FIG. 8, the display screen 33 a of the display device33 has a motion picture display area 61, a comment display area 62, astill image display area 63, a state-of-surgical instrument display area64, a patient information display area 65, an endoscopic informationdisplay area 66, and a thumbnail image display area 67. The motionpicture display area 61 is used to display an endoscopic motion image.The comment display area 62 is used to display character information.The still image display area 63 is used to display a captured stillimage. The state-of-surgical instrument display area 64 is used todisplay the state of a surgical instrument. The patient informationdisplay area 65 is used to display patient information. The endoscopicinformation display area 66 is used to display information concerning anendoscope, for example, the state of the light source apparatus set forillumination or the state of the imaging device set for signalprocessing. The thumbnail image display area 67 is used to displaythumbnail images.

[0138] According to the present embodiment, for example, the firstmonitor 22 has the motion picture display area 61, state-of-surgicalinstrument display area 64, patient information display area 65, andendoscopic information display area 66 that are shown in FIG. 8. Theseareas are used to display a motion picture of endoscopic Images, thestate of a surgical instrument, patient information, and endoscopicinformation, respectively.

[0139] On the first monitor 22, endoscopic images carried with a signalprocessed by the CCU 21 are displayed in the motion picture display area61. The state of a surgical instrument set using the controller 24 isdisplayed in the state-of-surgical instrument display area 64. Patientinformation input from the magnetic card reader 26 via the controller 24is displayed in the patient information display area 65. Endoscopicinformation sent from the controller 24 is displayed in the endoscopicinformation display area 66. The endoscopic information includes thetone setting and others for signal processing performed by the CCU 21,and the light adjustment setting for adjusting light emanating from thelight source apparatus.

[0140] The contents of display on the first monitor 22 are input fromthe CCU 21 to the controller 32 via the signal transmission apparatus 27and the signal transmission apparatus 28 in the remote control room 6.The same contents displayed on the first monitor 22 are displayed on thedisplay device 33.

[0141] When the surgeon in the operating room 5 has a comment that mustbe sent to the remote control room 6, the surgeon enters the comment atthe keyboard 29. The comment is then sent from the controller 24 to thecontroller 32 via the signal processing apparatus 27 and the signalprocessing apparatus in the remote control room 6. The contents of thecomment are displayed in the comment display area 62 on the displaydevice 33.

[0142] In the remote control room 6, when a motion picture displayed onthe display device 33 contains an image that must be captured, a captureinstruction is entered at the keyboard 34 connected to the controller32. The image is then captured as a still image, and the still image isdisplayed in the still image display area 62.

[0143] A mark indicating a region to be resected may be appended to thestill image displayed in the still image display area 63.

[0144] For displaying a thumbnail image of any of images accumulated inthe HDD 41, a thumbnail image display instruction is entered. Thethumbnail image is then displayed in the thumbnail image display area63.

[0145] A reply comment may be entered relative to a comment displayed inthe comment display area 67. A comment, such as a note explaining towhat should be paid attention during resection, may be entered.

[0146] Among the contents of the display on the display device 33, imageinformation, including a still image displayed in the still imagedisplay area 62 and the contents of a comment displayed in the commentdisplay area 67, are sent to the controller 32 via the signaltransmission apparatus 28 and the signal transmission apparatus 27 inthe operating room 5. The image information is then displayed on thesecond monitor 29.

[0147] The surgeon in the operating room 5 looks at the second monitor29 displaying the support information sent from the remote control room6, and carries out a surgical procedure such as resection.

[0148] When a plurality of surgical instruments is employed, the statesof the plurality of surgical instruments A and B, for example, are, asshown in FIG. 8, displayed in the state-of-surgical instrument displayarea 64.

[0149] According to the present embodiment, an endoscopic image, thestate of a surgical instrument, patient information, and endoscopicinformation that are the same as those displayed in the operating room 5can be displayed on the display device 33 in the remote control room 6all of the time. The settings or controlled states of almost allelectric equipment employed in a surgical procedure performed underendoscopic observation in the operating room 5 can be checked in theremote control room 6 all of the time.

[0150] For example, the setting of a surgical instrument may be modifiedusing the touch panel 25. Modification information is sent from thecontroller 24 to the CCU 21. The state of the surgical instrumentdisplayed in the state-of-surgical instrument display area 62 on thefirst monitor 22 is then modified and displayed. The set state of thesurgical instrument appended to image information sent from the CCU 21to the remote control room 6 via the signal transmission apparatus 27 isalso modified. The state of the surgical instrument displayed in thestate-of-surgical instrument display area 64 on the display device 33 isalso modified. In the remote control room 6, information set in theoperating room 5 is available nearly in real time without the necessityof performing any manipulation for acquiring needed information.

[0151] The surgeon in the operating room 5 can carry out a surgicalprocedure while taking account of information displayed on the secondmonitor 29 and viewing endoscopic images displayed on the first monitor22.

[0152] The present embodiment has nearly the same advantages as thefirst embodiment.

[0153] Patient information may be displayed in the comment display area62. Endoscopic information may not be displayed on the first monitor 22but may be sent from the controller 24 to the remote control room 6. Inthe remote control room 6, information items to be displayed may beselected.

[0154] A motion picture, the state of a surgical instrument, and patientinformation displayed on the first monitor 2 may be sent to the remotecontrol room 6 and displayed on, for example, the third monitor 31. Theother items of support information, that is, a still image and others,may be displayed on the display device 33.

[0155] Specifically, endoscopic images, the state of a surgicalinstrument, and patient information that are the same as those displayedon the first monitor 22 in the operating room 5 may be displayed in theremote control room 6. In the remote control room 6, when more supportinformation must be appended to these information items, a still image,containing information such as a mark, and thumbnail images displayed onthe display device 33 are referenced. Then, a support image, such as astill image having a mark appended thereto, or support informationincluding a comment may be sent to the operating room 5 and displayed onthe second monitor 29.

[0156] Depending on whether the operating room 5 and remote control room6 are linked by the public line 4, control of the display can besimplified. In either case, a display format according to whichinformation is displayed on the first monitor 22 remains unchanged. Thesurgeon in the operating room 5 will therefore be able to carry out asurgical procedure smoothly while referencing data displayed in the samedisplay format.

[0157] In the remote control room 6, endoscopic images, the state of asurgical-instrument, and patient information, which are arranged in thesame display format as they are on the first monitor 22 in the operatingroom 5, can always be referenced on the third monitor 31.

[0158] In the above embodiments, the remotely supporting surgeon may bepermitted to set an output value of electric energy supplied to anelectric cautery instrument or enter control information used to controlthe movement of a surgical instrument. Specifically, in cases where theremotely supporting surgeon can set a more proper value more readily,the remotely supporting surgeon may be permitted to send a controlsignal from the controller 32 to the controller 24 in the operating room5 using the keyboard 34 or touch panel. The movement of the surgicalinstrument 20 may be controlled based on the control signal.

[0159] Endoscopic images output from the CCU 21 may be displayed on thefirst monitor 22. Control information used to control a treatmentinstrument and patient information also may be input from the controller2 and superimposed on the endoscopic images.

[0160] The fourth embodiment of the present invention will be describedwith reference to FIG. 9 and FIG. 10.

[0161] A remote surgery support system 71 in accordance with the fourthembodiment of the present invention, shown in FIG. 9 and FIG. 10, has asurgery system 72 and a remote support system 73 linked by a public line72, such as the integrated services digital network (ISDN). The remotesupport system 73 is located remotely to the surgery system 72. Thesurgery system 72 and remote support system 73 are installed in anoperating room 75 and a remote room or a remote control room 76,respectively.

[0162] The surgery system 72 installed in the operating room 75 has anendoscopic imaging apparatus 78 to observe a patient 77 with anendoscope and a surgical instrument 79 to perform surgery underendoscopic observation. The surgical instrument 79 may be an electriccautery instrument, a pneumoperitoneum unit, or an ultrasonic surgicalinstrument.

[0163] The endoscopic imaging apparatus 78 and surgical instrument 79are connected to a first controller 80 for controlling the surgicalinstrument 79 and the first controller 80.

[0164] To be more specific, the surgical instrument 79 has, as shown inFIG. 10, a surgical instrument body 81, such as an electric cauteryinstrument, and a power supply unit 82 for supplying operating power tothe surgical instrument body 81. The surgical instrument body 81 isadvanced into the abdominal cavity of the patient 77 to perform surgery.

[0165] The endoscopic imaging apparatus 78 has an optical endoscope 83to observe a surgical scene. A TV camera 85 with a built-in solid-stateimaging device, for example, a built-in charge couple device (CCD) 84 ismounted on the endoscope 83, providing an endoscopic imaging means forproducing endoscopic images.

[0166] According to the present embodiment, the endoscope 83 is, forexample, a rigid endoscope having a rigid insertion unit 86. The TVcamera 85 is mounted on an eyepiece unit 87 formed at the back end ofthe insertion unit 86 so that the TV camera can be dismounted freely.

[0167] The endoscope 83 is connected to a light source apparatus 88 witha light guide cable 89. Light emanating from a lamp (not shown) in thelight source apparatus 88 is propagated over a light guide contained inthe light guide cable 89 and a light guide running through the endoscope83. The propagated light is emitted from the distal end surfaces of thelight guides fixed in an illumination window formed at the distal end ofthe insertion unit 87. An object, such as an intracavitary organ, isthus illuminated.

[0168] An objective lens (not shown) is fixed in an observation windowadjoining the illumination window, and forms an optical image of theobject. The optical image is propagated backwardly along an opticalimage propagating means incorporated in the insertion unit 84, forexample, a system of relay lenses. Consequently, the image of the objectcan be viewed in enlarged proportions through an eyepiece (not shown) inthe eyepiece unit 87 formed at the back end of a hand-held portion. Theoptical image propagating means incorporated in the endoscope 83 may bean image guide formed with a fiber bundle rather than the system ofrelay lenses.

[0169] A propagated optical image is projected on the CCD 84 via animage formation lens 90 of the TV camera 85. The TV camera 85 is mountedon the eyepiece unit 87 so that the TV camera can be dismounted freely.The CCD 84 is connected to a camera control unit (CCU) 91 with a signalcable. A signal photoelectrically converted by the COD 84 is processedto produce a standard video signal. The video signal is then output tothe first monitor 92. Consequently, endoscopic images representing anintracavitary organ and the distal part of the surgical instrument body11 used to perform surgery on the organ projected on the CCD 84 aredisplayed on the first monitor 92.

[0170] The CCU 91 and power supply unit 82 are connected to a controller80 for controlling the CCU 91 and the power supply unit 82.

[0171] The controller 80 is also connected to a touch panel 95 or thelike used to enter an instruction for controlling operations, and amagnetic card reader or the like (not shown) for inputting patient data.

[0172] The touch panel 95 may be used to control the CCU 91 via thecontroller 80 so as to change tones or the like. The movement of thesurgical instrument body 81 of the surgical instrument 79 may becontrolled using the touch panel 95. When the surgical instrument body81 is, for example, an electric cautery instrument, the output level ofelectric energy supplied from the power supply 82 to the electriccautery instrument for the purpose of incision or coagulation can be setusing the touch panel 95.

[0173] According to the present embodiment, the CCU 91 of the endoscopicimaging apparatus 78 is connected to a first image transmissionapparatus 97 serving as a signal transmitting means via a signalisolating means, for example, a video transformer 96. Specifically,endoscopic images produced by the endoscopic imaging apparatus 78 areconverted into a video signal using the CCU 91. The video signal isapplied to the primary winding of the video transformer 96 enablingtransmission of a signal having frequency components in a wide frequencyband. The secondary winding of the video transformer 96 is connected tothe image transmission apparatus 97. Thus, the video signal is suppliedto the image transmission apparatus 97 with electrical isolation betweenthe CCU 91 and image transmission apparatus 97 maintained.

[0174] The image transmission apparatus 97 converts the video signal,which is input from the CCU 91, into a signal transmissible over thepublic line 74, so that the signal can be transmitted to a second imagetransmission apparatus 98 in the remote control room 76 over the publicline 74. The image transmission apparatuses 97 and 98 can transmit animage signal having frequency components in a wide frequency band. Acontrol signal or voice signal having lower frequency components cantherefore be transmitted.

[0175] The controller 80 in the operating room 75 is connected to theimage transmission apparatus 97 via signal isolating means, for example,optical modems 99. The optical modems 99 in the controller 80 and imagetransmission apparatus 97 are linked by an optical cable. A converterfor converting an electric signal into an optical signal is attached tothe end of the optical cable coupled to the controller 80. A converterfor converting the optical signal into an electric signal is attached tothe end of the optical cable coupled to the image transmission apparatus97. The controller 80 is connected to the image transmission apparatus97 via the signal isolating means.

[0176] The image transmission apparatus 97 converts a signal, which hasbeen sent from the image transmission apparatus 98 in the remote controlroom 76 to the image transmission apparatus 97 over the public line 74,into a video signal. The video signal is output to the second monitor102, which is isolated from the image transmission apparatus 97, via asecond video transformer 101 connected to the image transmissionapparatus 97. Image information sent from the image transmissionapparatus 98 can be displayed on a second monitor 102. The secondmonitor 102 is connected to the image transmission apparatus 97 via thesignal isolating means.

[0177] A control signal used to control the surgical instrument 79 sentfrom the controller 80, or patient data read with a magnetic card readerinput to the controller 80, are input to the image transmissionapparatus 97 via the optical modems 99. The image transmission apparatus97 converts the input signal into a signal transmissible over the publicline 74, and transmits the resultant signal to the image transmissionapparatus 98 in the remote room 76 over the public line 74.

[0178] According to the present embodiment, electric equipment areconnected to the image transmission apparatus 97 in the operating room75 via the signal isolating means. If the public line 74 is struck bylightning, the electric equipment connected to the image transmissionapparatus 97 can be protected from being damaged. This eliminates thepossibility that a surgeon using the electric equipment to carry out asurgical procedure and the patient 77 undergoing surgery performed usingthe treatment instrument 79 may experience an electric shock. Thus,safety is ensured.

[0179] Patient data read from a magnetic card using a magnetic cardreader is input to the controller 80. The controller 80 may output thepatient data to the CCU 91 so that the patient data will be superimposedon endoscopic images. Otherwise, the controller 80 may output thecontents of control to be imparted to the surgical instrument 79 to theCCU 91 so that the controlled or set state of the surgical instrument 79will be superimposed on the endoscopic images.

[0180] The remote support system 73 in the remote room 76 has a thirdmonitor 104 connected to the image transmission apparatus 98. Endoscopicimages or the like sent from the operating room 75 are displayed on thethird monitor 104.

[0181] The image transmission apparatus 98 is connected to an indoorcamera 105. A video signal produced by the indoor camera 105 is outputto the second monitor 102 via the image transmission apparatuses 98 and97 over the public line 74. The video signal carries support images of aremotely supporting surgeon 106, or material or an explanatory diagramindicating a region to be resected during surgery. The region to beresected is indicated by the remotely supporting surgeon 106.

[0182] A voice microphone 107 is attached to the indoor camera 105. Avoice signal originating from the remotely supporting surgeon 106 istherefore transmitted to the operating room 75, and reproduced with aloudspeaker (not shown) of the second monitor 102. Thus, the remotelysupporting surgeon 106 can give advice or the like to a surgeon (notshown) in the operating room 75 during surgery.

[0183] Next, actions to be made in accordance with the presentembodiment will be described.

[0184] The image transmission apparatuses 97 and 98 are electricallyconnected over the public line 74. On receipt of a video signalrepresenting endoscopic images sent from the CCU 91 or a control signaland patient data sent from the controller 77, the image transmissionapparatus 97 converts the input signal into a signal transmissible overthe public line 74. The resultant signal is transmitted to the imagetransmission apparatus 98 in the remote control room 76 over the publicline 74. The image transmission apparatus 98 converts the receivedsignal that has been transmitted over the public line 74, and outputs aresultant signal to the third monitor 104. The endoscopic images and thecontrol to be imparted to the surgical instrument 79 and the patientdata are displayed on the third monitor 104.

[0185] The indoor camera 105 is connected to the image transmissionapparatus 98. The indoor camera 105 images the remotely supportingsurgeon 106 in the remote control room 76 or an explanatory diagram usedfor surgery. The image transmission apparatus 98 converts the imagesignal into a signal transmissible over the public line 74, andtransmits the resultant signal to the image transmission apparatus 97 inthe operating room 75 over the public line 74.

[0186] Images produced by the indoor camera 105 are displayed on thesecond monitor i02 via the image transmission apparatus 97 and videotransformer 101. Verbal advice given by the remotely supporting surgeon106 also is transmitted in the same manner, and reproduced with aloudspeaker (not shown) together with the images displayed on thedisplay screen of the second monitor 102.

[0187] The surgeon in the operating room 75 can carry out a surgicalprocedure properly owing to the images displayed on the second monitor102 and support such as the advice received along with the images.

[0188] Owing to the foregoing components and operations, for example,even if the public line 74 is struck by lightning, the first monitor 92,second monitor 102, CCU 91, and controller 80 can be protected frombeing damaged. This is because the electric equipment connected to theimage transmission apparatus 97 in the operating room 75 areelectrically isolated due to the video transformers 96 and 101 and theoptical modems 99. Consequently, the possibility that an surgeonhandling the electric equipment and the patient 77 connected to theelectric equipment may experience an electric shock can be eliminatedreliably.

[0189] According to the present embodiment, even if the public line 74is struck by lightning, since the electric equipment connected to theimage transmission apparatus in the operating room 73 are electricallyisolated from one another, the electric equipment can be protected frombeing damaged. Moreover, the possibility that the patient 77 and surgeonmay experience an electric shock can be eliminated reliably.

[0190] Photocouplers or the like may be adopted as the signal isolatingmeans instead of the video transformers 96 and 101. A video signal orthe like may thus be transmitted.

[0191] The endoscopic imaging apparatus 78 in accordance with thepresent embodiment has an endoscope with an external TV camera havingthe TV camera 85 with the built-in CCD 84 mounted on the opticalendoscope 83. The present invention can also be adapted for anelectronic endoscope having the CCD 84 incorporated in the distal partof an insertion unit thereof.

[0192] The fifth embodiment of the present invention will be describedwith reference to FIG. 11. FIG. 11 shows the configuration of a remotesurgery support system 111 in accordance with the fifth embodiment ofthe present invention. The remote surgery support system 111 has theelectric equipment connected to the image transmission apparatus 98 inthe remote support system room 76, which is shown in FIG. 10, via signalisolating means.

[0193] To be more specific, the image transmission apparatus 98 isconnected to the third monitor 104 and indoor camera 105 via videotransformers 112 and 113. The other components are identical to those ofthe fourth embodiment. The same reference numerals will be assigned tothe components identical to those of the fourth embodiment. Thedescription of the components will be omitted.

[0194] Actions made in accordance with the present embodiment are nearlyidentical to those with the fourth embodiment. For example, if thepublic line 74 is struck by lightning, the electric equipment connectedto the image transmission apparatus 87 in the surgery system 72 areprotected from being damaged as they are in the fourth embodiment.Moreover, the possibility that the surgeon and patient 77 may experiencean electric shock is reliably eliminated as it is in the fourthembodiment. In addition, the electric equipment connected to the imagetransmission apparatus 98 in the remote control room 73, or moreparticularly, the third monitor 104 and indoor camera 105 can beprotected from being damaged.

[0195] According to the present embodiment, the electric equipmentconnected to the image transmission apparatus 97 in the surgery system72 can be protected from being damaged. The possibility that the surgeonand patient 77 may experience an electric shock can be eliminatedreliably. The electric equipment connected to the image transmissionapparatus 98 in the remote support system 73 also can be protected frombeing damaged.

[0196] When the remotely supporting surgeon 106 handles the electricequipment connected to the image transmission apparatus 93, thepossibility that the remotely supporting surgeon 106 may experience anelectric shock can be eliminated reliably.

[0197] The sixth embodiment of the present invention will be describedwith reference to FIG. 12. FIG. 12 shows the configuration of a remotesurgery support system 121 in accordance with the sixth embodiment ofthe present invention.

[0198] Instead of connecting the controller 80 and the imagetransmission apparatus 97 via the optical modems 99, as shown in FIG.10, the remote surgery support system 121 has the controller 80connected to a first infrared transmitter receiver or IR transmitterreceiver 122, in FIG. 12. The image transmission apparatus 97 isconnected to a second infrared transmitter receiver 123. The first andsecond infrared transmitter receivers 122 and 123 communicate with eachother in a wireless state using infrared light. Thus, image informationor the like can be communicated with the electrical isolation betweenthe controller 80 and image transmission apparatus 97 maintained.

[0199] The other components are identical to those of the fifthembodiment.

[0200] Operations to be executed by the present embodiment will bedescribed. The present embodiment is different from the fifth embodimentin terms of an operation to be executed by a unit for transmitting acontrol signal or the like sent from the controller 80 to the imagetransmission apparatus 98. The unit will be described below.

[0201] An electric signal, such as a control signal sent from thecontroller 80, is converted into an infrared signal by the infraredtransmitter receiver 122, and transferred to the infrared transmitterreceiver 123. The infrared transmitter receiver 123 receives theinfrared signal, converts it into an electric signal, and supplies theelectric signal to the image transmission apparatus 97. The imagetransmission apparatus 97 transmits the signal to the image transmissionapparatus 98 over the public line 74 The image transmission apparatus 98outputs the signal to the third monitor 104 via the connected videotransformer 112. The signal is then superimposed on a video signalcarrying endoscopic images sent from the CCU 91.

[0202] If the public line 74 is struck by lightning, almost the sameoperation as that by the fifth embodiment is expected. Namely, theelectric equipment connected to the image transmission apparatus 97 inthe surgery system 72 can be protected from being damaged, and thepossibility that the surgeon and patient 77 may experience an electricshock can be eliminated reliably. The electric equipment connected tothe image transmission apparatus 98 in the remote support system 73 alsois protected from being damaged.

[0203] According to the present embodiment, the controller 80 and imagetransmission apparatus 97 communicate with each other in a wirelessmanner using infrared light. Alternatively, the infrared communicationmeans may be substituted for the video transformer 86 or 101 connectedbetween the image transmission apparatus 97 and CCU 91 or between theimage transmission apparatus 97 and second monitor 102.

[0204] The present embodiment has nearly the same advantages as thefifth embodiment. Namely, the electric equipment connected to the imagetransmission apparatus 97 in the surgery system 72 can be protected frombeing damaged, and the possibility that the surgeon and patient 77 mayexperience an electric shock can be eliminated reliably. The electricequipment connected to the image transmission apparatus 98 in the remotesupport system 73 also is protected from being damaged.

[0205] When the remotely supporting surgeon 106 handles the electricequipment connected to the image transmission apparatus 98, thepossibility that the remotely supporting surgeon 106 experiences anelectric shock can be eliminated reliably.

[0206] An apparatus designed for infrared wireless communication may besubstituted for the video transformer 112 or 113 in the remote room 76.

[0207] The seventh embodiment of the present invention will be describedwith reference to FIG. 13. FIG. 13 shows the configuration of a remotesurgery support system 131 in accordance with the seventh embodiment ofthe present invention.

[0208] According to the present embodiment, the remotely supportingsurgeon 106 in the remote room 76 shown in FIG. 12 can operate thecontroller 94 in the operating room 75 so as to send a control signalused to control the surgical instrument 79. Specifically, a touch panel132 or a keyboard is an input means, and a controller 133 is includedfor producing a control signal according to an entry made bymanipulating the touch panel 132. The controller 133 is connected to theimage transmission apparatus 98 via optical modems 134 serving as signalisolating means. The other components are identical to those of thesixth embodiment.

[0209] One of operations to be executed by the present embodiment issuch that the remotely supporting surgeon 106 can control the surgicalinstrument 79 or can set parameter values for the surgical instrument79. In other words, depending on the surgery, the remotely supportingsurgeon 106 may be able to set more appropriate parameter values,including an output value of electric energy supplied to, for example,an electric cautery instrument used for resection. The presentembodiment would prove useful in this kind of case.

[0210] The other operations are nearly identical to these of the sixthembodiment.

[0211] The present embodiment has nearly the same advantages as thesixth embodiment.

[0212] The wireless communication means is not limited to the infraredcommunication means but may use a high-frequency electromagnetic wave orthe like.

[0213] The controller 133 in the remote room 76 has the ability totransmit a control signal, which is produced according to an entry madeat the touch panel 132, to the operating room 75 via the optical modems134 and image transmission apparatus 98. A video signal of endoscopicimages or a control signal transmitted from the CCU 91 or controller 80in the operating room 75 may be input to the controller 133 via theimage transmission apparatus 98 and optical modems 134. A video capturecontrol unit for capturing a video signal or an I/O interface in thecontroller 133 captures the video signal. The position of a region to beresected during surgery may then be marked in images carried by thevideo signal. The video signal may then be returned to the operatingroom.

[0214] A display device, such as a monitor, may be connected to thecontroller 133 so that images captured by the video capture control unitin the controller 133 or information indicated with a control signal canbe displayed as an overlay.

[0215] A communication line linking the operating room and remote roommay be, aside from the public line 74, a local area network (LAN) or awide area network (WAN).

[0216] A medical information processing system will be described withreference to FIG. 14 to FIG. 18. The medical information processingsystem is intended to improve the efficiency of retrieving medicalinformation, including a plurality of different kinds of image data thathave relation to one another, so as to thus improve the efficiency ofworking on information at a medical institute or the like.

[0217] As shown in FIG. 14, a medical information processing systemconsists mainly of an operating room system 201, a plurality ofexamination room systems 202, an information accumulation system 203,and an information reference apparatus 204. The operating room system201 is installed in an operating room or any other site and acquiresendoscopic image data, surgery system information, and patientinformation. The examination room apparatuses 202 are installed inexamination rooms dedicated to examinations performed using an MRIsystem, a CT scanner, a diagnostic ultrasound system, and an X-raysystem and acquire a plurality of kinds of image data different fromendoscopic image data. The information accumulation system 203 isinstalled in a site other than the operating room and the examinationrooms, accumulates various kinds of image data acquired by the operatingroom system 201 and the examination room systems 202 and non-image data,and produces clinical recordings. The information reference apparatus204 is used to reference medical information accumulated in theinformation accumulation system 203. The operating room system 201 andthe information accumulation system 203, the examination room systems202 and the information accumulation system 203, and the informationreference apparatus 204 and the information accumulation system 203 arelinked by public lines or any other communication lines 205, 206, and207, respectively.

[0218] The operating room system 201 consists mainly of an endoscopesystem 211, a display device 212, a surgical apparatus 213, a controlapparatus 214, a manipulating means, such as an operator panel 215, apatient information input means, such as a magnetic card reader 216, asignal transmission apparatus 217, and a display device 218. Theendoscope system 211 images a region to be examined in a patients bodycavity and acquires endoscopic image data. The display device 212displays endoscopic images produced by the endoscope system 211. Thesurgical apparatus 213 is, for example, an electric cautery instrument,a pneumoperitoneum unit, or an ultrasonic surgical apparatus. Thecontrol apparatus 214 has the ability to acquire surgical apparatusinformation, such as measurement information provided by the surgicalapparatus 213. The operator panel 215 is connected to the controlapparatus 214 to input a control instruction or the like, according towhich the surgical apparatus 213 should be controlled, to the controlapparatus 214. The magnetic card reader 216 reads patient informationfrom a magnetic card and supplies it to the control apparatus 214. Thesignal transmission apparatus 217 transmits endoscopic image data,surgical apparatus information, and patient information to theinformation accumulation system 203 installed in another site over acommunication line 205, and communicates with the informationaccumulation system 203 so as to receive data. The display device 218displays surgical apparatus information and patient information suppliedfrom the control apparatus 214 and information received from the othersites via the signal transmission apparatus 217.

[0219] The examination room systems 202 include various examinationsystems (not shown), image filing apparatuses 221, and a communicatingmeans, such as a modem 222. The examination systems include an MRIsystem, a CT scanner, a diagnostic ultrasound system, and an X-raysystem. The image filing apparatuses 221 accumulate image data acquiredby the examination systems. The modem 222 connects the image filingapparatuses 221 to the other sites over communication lines 206. Theimage data accumulated in the image filing apparatuses 221 can betransmitted to the other sites. The image data stored in theimage-filing apparatuses 221 may not be solely image data but maycontain non-image data, such as data associated with the image data, forexample, findings.

[0220] The information accumulation system 203 consists mainly of asignal transmission apparatus 231, a display device 232, an informationaccumulation apparatus 233, a display device 234, a printer 235, and acommunicating means, such as a modem 236. The signal transmissionapparatus 231 communicates with the signal transmission apparatus 217.The display device 232 displays endoscopic image data, surgicalapparatus information, and patient information received from the othersites via the signal transmission apparatus 231. The informationaccumulation apparatus 233 accumulates medical information, such as theendoscopic image data, surgical apparatus information, and patientinformation received from the other sites via the signal transmissionapparatus 231, and image data other than the endoscopic image data. Theinformation accumulation apparatus also edits the medical information.The display device 234 displays the medical information accumulated inthe information accumulation apparatus 233. The printer 235 printsclinical records of edited medical information accumulated in theinformation accumulation apparatus 233. The modem 236 enables transferof the medical information between the examination room systems 202 orinformation reference apparatus 204 and the information accumulationapparatus 233.

[0221] The information reference apparatus 204 consists of acommunicating means, such as a modem 241, and a terminal unit 242. Themodem 241 enables transfer of medical information to or from the othersites. The terminal unit 242 is used to reference the medicalinformation accumulated in the information accumulation system 203 viathe modem 241. The terminal unit 242 may be designed, if necessary toedit the medical information accumulated in the information accumulationsystem 203.

[0222] As shown in FIG. 15, the information accumulation apparatus 233consists mainly of a control circuit 251, a video signal input/outputcircuit 252, a communication interface 253, a display control circuit254, and a printing control circuit 255. The control circuit 251controls the components of the information accumulation apparatus 233.The video signal input/output circuit 252 inputs to or outputs from thesignal transmission apparatus 231 endoscopic image data. Thecommunication interface 253 enables input or output of medicalinformation between the signal transmission apparatus 231 and modem 236.The display control circuit 254 is controlled by the control circuit 251and outputs a video signal used to drive the display device 234. Theprinting control circuit 255 is controlled by the control circuit 251and outputs a video signal used to drive the printer 235.

[0223] The control circuit 251 has such hardware devices as a processor251 a, a memory 251 b, and a hard disk 251 c. The processor 251 a isoperated by software. Software programs to be run by the processor 251 aand medical information are stored in the memory 251 b and hard disk 251c. A work area to be used by the processor 251 a is preserved in thememory 251 b.

[0224] The video signal input/output circuit 252 consists of acontroller 252 a, an encoder decoder 252 b, an A/D converter 252 c, anda D/A converter 252 b. The controller 252 a controls the circuitelements of the video signal input/output circuit 252. the encoderdecoder 252 b encodes or decodes image data. the A/DI converter 252 cconverts input image data fro an analog form to a digital form. The D/Aconverter 252 b converts the image data from the digital form to theanalog form.

[0225] As shown in FIG. 16, the control circuit 251 has such functionalelements as a data memory 261, a data saver 262, a data retriever 263, ascreen editor 264, and a clinical record editor 265. The data memory 261is used to store data. The data saver 262 saves data, which is input viathe video signal input-output circuit 252 and communication interface253, in the data memory 261. The data retriever 263 retrieves and readsdata from the data memory 261. The screen editor 264 edits data read bythe data retriever 263 according to a screen display format. Theclinical record editor 265 edits data read by the data retriever 263according to a printout format of clinical records.

[0226] As shown in FIG. 17, a medical information display screen 271displayed with the display device 234 by means of the informationaccumulation apparatus 233 consists of a view image area 272, athumbnail image area 273, a patient information area 274, a surgicalapparatus information area 275, and an operation menu display area 276.View images, including endoscopic images, are displayed in the viewimage area 272. A plurality of thumbnail images produced by reducingimage data, for example, thinning pixels constituting image data, isdisplayed in the thumbnail image area 273. Patient information isdisplayed in the patient information area 274. Surgical apparatusinformation is displayed in the surgical apparatus information area 275.The operation menu display area 276 is used to execute such an operationas retrieval of medical information or display of images. A button 277to initiate retrieval of medical information.

[0227] Other buttons also are arranged in the operation menu displayarea 276. The buttons initiate other operations. When a button isselected using a mouse or the like (not shown), an allocated utility isactivated.

[0228] As shown in FIG. 18, a clinical record printout 281 output fromthe printer 235 driven by the information accumulation apparatus 233 hasa view image area 282, a thumbnail image area 283, and a patientinformation area 284 arranged therein.

[0229] Operations executed by the present embodiment will be describedbelow.

[0230] Prior to surgery, a magnetic card in which patient information isstored is inserted into the magnetic card reader 216. The patientinformation read by the magnetic card reader 216 is supplied to thecontrol apparatus 214. When surgery starts, the endoscope system 211 andsurgical apparatus 213 are employed.

[0231] The endoscope system 211 is used to image a region to be observedin a patient's body cavity. A video signal containing endoscopic imagedata produced by the endoscope system 211 is output to the displaydevice 212. Endoscopic images are then displayed on the display device212. The operator panel 215 may be manipulated to control the endoscopesystem 211, that is, to adjust the tone of the endoscopic images. Thecontrol apparatus 214 controls the endoscope system 211 according to themanipulation.

[0232] The operator panel 215 may be manipulated in order to control thesurgical apparatus 213. The control apparatus 214 then controls thesurgical apparatus 213 according to the manipulation. When the surgicalapparatus 213 is controlled, power output to the electric cauteryinstrument or pressure applied to an abdominal cavity by apneumoperitoneum unit is set to a certain level. Measurement informationprovided by the surgical apparatus 213 is given to the control apparatus214. The measurement information pertains to, for example, pressureactually applied to a patient's abdominal cavity by the pneumoperitoneumunit. Thus, the patient information sent from the control apparatus 214and surgical apparatus information are displayed on the display device18. The surgical apparatus information contains information of the stateof the endoscope system 211, information of the state of the surgicalapparatus 213, and the measurement information provided by the surgicalapparatus 213.

[0233] Endoscopic image data produced by the endoscope system 211, andpatient information and surgical apparatus information sent from thecontrol apparatus 214 are supplied to the signal transmission apparatus231 in the information accumulation system 203 over the communicationline 205. The signal transmission apparatus 231 transfers the inputendoscopic image data, patient information, and surgical apparatusinformation to the display device 232 connected to the signaltransmission apparatus 231. The signal transmission apparatus 231 alsotransfers the data and information to the information accumulationapparatus 233. For transmitting image data, if necessary, the signaltransmission apparatus 217 encodes or decodes the image data.

[0234] MRI data, CT image data, ultrasonic image data, and radiographicimage data acquired in the examination rooms are accumulated in theimage filing apparatuses 221 in the examination rooms. The image dataaccumulated in the image filing apparatuses 221 are transmitted to theinformation accumulation apparatus 233 by way of the modems 222,communication lines 206, and modem 236.

[0235] As mentioned above, medical information, composed of endoscopicimage data, patient information, surgical apparatus information, andvarious kinds of image data other than the endoscopic image data, istransmitted to the information accumulation apparatus 233 via the signaltransmission apparatus 231 and modem 236 serving as communicating means.The endoscopic image data sent to the information accumulation apparatus233 via the signal transmission apparatus 231 are transferred to thevideo signal input/output circuit 252. The endoscopic image data areconverted into digital data or, if necessary, decoded, and then appliedto the control circuit 251.

[0236] The patient information, surgical apparatus information, andvarious kinds of image data sent to the information accumulationapparatus 233 via the signal transmission apparatus 231 and modem 236are transferred to the control circuit 251 via the communicationinterface 253.

[0237] The medical information transferred to the control circuit 251 issaved in the data memory 261 by the data saver 262. The data saver 262associates relevant medical information, for example, sorts medicalinformation by patient name and then saves associated information in thedata memory 261. For sorting and saving medical information in the datamemory 261, for example, relevant medical information may be integratedinto one file.

[0238] For retrieving desired medical information from the data memory261, for example, the button 277 in the operation menu display area 276in the medical information display screen 271 selected with a mouse orthe like (not shown). A screen for prompting selection of keys relevantto retrieval (not shown) then appears. The keys relevant to retrievalare then pressed with the screen displayed. This causes the dataretriever 263 to retrieve and read medical information designated withthe pressed keys from the data memory 261.

[0239] For example, assuming that a patient name, a patient code, or thelike for identifying a patient is keyed in, medical informationconcerning the designated patient is then read from the data memory 261.Image data of the medical information may be, if necessary, convertedinto thumbnail image data, expressing reduced images, and output.

[0240] The screen editor 264 edits medical information retrieved by thedata retriever 263 according to a screen display format. The resultantmedical information is displayed on the display device 234 via thedisplay control circuit 254 with respective information items allocatedto the display areas of the medical information display screen 271. Thethumbnail images produced by reducing in size image data, for example,are displayed in the thumbnail image area 273. Surgical apparatusinformation is displayed in the surgical apparatus information area 275,and patient information is displayed in the patient information area274.

[0241] In the thumbnail image area 273, not only endoscopic images, butalso various kinds of images other than the endoscopic images aredisplayed. When any of one or more thumbnail images displayed in thethumbnail image area 273 is designated with a mouse or the like (notshown), a full-sized image associated with the designated thumbnailimage appears in the view image area 272. In the view image area 272,not only an endoscopic image, but also any of the other various kinds ofimages can be displayed if necessary.

[0242] The clinical record editor 265 edits medical informationretrieved by the data retriever 263 according to a clinical recordprintout format. The resultant medical information is then supplied tothe printing control circuit 255. Consequently, the printer 235 providesthe clinical record printout 281.

[0243] Medical information retrieved by the data retriever 263 is alsooutput to the display device 218 by way of the video signal input/outputcircuit 252, communication interface 253, signal transmission apparatus231, communication line 205, and signal transmission apparatus 217.Image data output from the control circuit 251 are, if necessary,encoded by the video signal input/output circuit 252, converted intoanalog data, and then transmitted to the signal transmission apparatus231.

[0244] In response to a request for retrieval of medical information,the data retriever 263 retrieves and reads designated medical data fromthe data memory 261 by way of the terminal unit 242, modem 241,communication line 207, modem 236, and communication interface 253. Themedical data then are transmitted to the terminal unit 242.

[0245] The information accumulation system 203 may be used as, forexample, the remote support system 6 included in the first embodiment tosupport surgery.

[0246] An operator of the information accumulation system 203 displaysendoscopic image data and patient data, which are sent from theoperating room system 201, on the display device 232 so as to monitorthe progress of surgery. Information relevant to the surgery isdisplayed on the display device 234. According to the first embodiment,data stored in the remote support system 6 are utilized as informationrelevant to surgery. According to the present embodiment, anyinformation can be retrieved from the examination room systems 202 orthe like.

[0247] Information useful in supporting an a surgeon, such as imagesrepresenting what must be noted for surgery, is output to the displaydevice 218 via the signal transmission apparatus 231 and the signaltransmission apparatus 217 in the operating room system 201.

[0248] As described above, according to the present embodiment, medicalinformation, including a plurality of different kinds of correlatedimage data, is stored while being associated. The medical information,including the plurality of different kinds of correlated image data, canbe retrieved easily.

[0249] According to the present embodiment, the efficiency in retrievingmedical information, including a plurality of different kinds ofcorrelated image data, improves. This improves the efficiency in workingon information at a medical institution.

[0250] The present embodiment is not limited to the aforesaid mode.Various variants of the present embodiment can be made without adeparture from the spirit of the present invention.

[0251] Specifically, the communication lines 205, 206, and 207 are notlimited to public lines, but may be leased lines, local area networks(LAN), or any other communication lines. The information referenceapparatus 204 may be installed in the same site as the operating roomsystem 201 or the examination room systems 202. The examination roomsystems 202 may be installed in the same site as the operating roomsystem 201 or the information accumulation system 203.

[0252] According to the present embodiment, an input means for inputtingpatient information is provided with the magnetic card reader 216.However, the input means is not limited to the magnetic card reader.Alternatively, an apparatus for reading patient information from an ICcard, an optical card, or any other medium other than the magnetic cardmay be used.

[0253] The image filing apparatus 221 may be provided with a computerhaving a display facility.

[0254] The terminal unit 242 may be provided with a computer having adisplay utility.

[0255] The information accumulation apparatus 233 may have the abilityto display medical information read from the data memory 261 as well asmedical information retrieved, if necessary, by way of the signaltransmission apparatus 231 and modem 236 on the medical informationdisplay screen 271 instead of accumulating the medical information.

[0256] The modems 222, 236, and 241 may be replaced with any othercommunicating means, for example, terminal adaptors or routers.

[0257] Retrieval-related keys to be pressed for retrieving medicalinformation from the data memory 261 are not limited to keys identifyinga patient, but may be any other keys. For example, keys indicating adate of surgery, an operator, or identifying a kind of case may be used.A plurality of sets of keys may be used in combination. Related medicalinformation is stored in the data memory 216 according to the set ofkeys to be employed.

[0258] According to the present embodiment, image data is transmittedfrom a remote site to the information accumulation system over acommunication line. The present embodiment is not limited to this mode.Alternatively, a portable magneto-optical disk or the like on whichimage data is stored may be transported from a remote site to theinformation accumulation system. Image data may be saved from therecording medium to the information accumulation apparatus.

[0259] A medical information processing system facilitating efficiencyin producing clinical recordings by saving time required for acquiringand accumulating medical treatment information will be described withreference to FIG. 19 to FIG. 22.

[0260] As shown in FIG. 19, a medical information processing system ofthe present embodiment consists mainly of an operating room system 301,an information accumulation system 302, and an information referenceapparatus 303. The operating room system 301 is installed in anoperating room or any other site, and acquires various kinds of medicalinformation in the operating room or the like. The informationaccumulation system 302 is installed remotely from the operating room301, accumulates various kinds of medical treatment information acquiredby the operating room system 301, and produces clinical records. Theinformation reference apparatus 303 is installed in a site differentfrom the site in which the information accumulation system 302 isinstalled, and is used to reference clinical record information producedby the information accumulation system 302. The operating room system301 and information accumulation system 302 and the informationaccumulation system 302 and information reference apparatus 303 arelinked by communication lines 304 and 305, respectively.

[0261] The communication lines 304 and 305 may be public lines, leasedlines, local area networks (LAN), or any other communication lines. Theinformation reference apparatus 303 may be installed in the same site asthe operating room system 301.

[0262] The operating room system 301 consists mainly of an endoscopesystem 311, a display device 312, a surgical apparatus 313, a controlapparatus 314, a surgical apparatus control input means, such as a touchpanel 315, patient information input means, such as a magnetic cardreader 316, a signal transmission apparatus 317, and a display device318. The endoscope system 311 images a region to be examined, such as apatient's intracavitary region, and produces a video signal containingendoscopic image data. The display device 312 displays an imagecorresponding to a video signal produced by the endoscope system 311.The surgical apparatus 313 is, for example, an electric cauteryinstrument, a pneumo-peritoneum unit, or an ultrasonic surgicalapparatus. The control apparatus 314 controls the surgical apparatus 313and produces surgical apparatus information, including measurementinformation supplied from the surgical apparatus 313. The touch panel315 is connected to the control apparatus 314 and used to enter acontrol instruction or the like, according to which the surgicalapparatus 313 is controlled, to the control apparatus 314. The magneticcard reader 316 reads patient information from a magnetic card andsupplies it to the control apparatus 314. The signal transmissionapparatus 317 transmits a video signal, surgical apparatus information,and patient information to the information accumulation system 302located in another site over a communication line, and communicates withthe information accumulation system 302 so as to receive informationtherefrom. The video signal contains endoscopic image data produced bythe endoscope system 311. The surgical apparatus information is suppliedfrom the control apparatus 314. The display device 318 displays thesurgical apparatus information and patient information supplied from thecontrol apparatus 314 or information received from another site by thesignal transmission apparatus 317.

[0263] The information accumulation system 302 consists mainly of asignal transmission apparatus 321, a display device 322, a controlapparatus 323, a display device 324, a printer 325, and a communicatingmeans, such as a modem 326. The signal transmission apparatus 321communicates with the signal transmission apparatus 317. The displaydevice 322 displays endoscopic image information, surgical apparatusinformation, and patient information received from another site via thesignal transmission apparatus 321. The control apparatus 323 accumulatesmedical treatment information, including the endoscopic imageinformation, surgical apparatus information, and patient informationreceived from another site via the signal transmission apparatus 321,and produces a video signal for generating a screen into which theimages and information are integrated. The control apparatus 323 alsohas the ability to integrate and edit the information so as to produce aclinical record, and to output the clinical record to the printer. Thedisplay device 324 displays the information integrated by the controlapparatus 323. The printer 325 prints out the clinical record producedby the control apparatus 323. The modem 326 helps transmit theinformation, which is integrated by the control apparatus 323, to theinformation reference apparatus 303 in another site over thecommunication line 305.

[0264] The information reference apparatus 303 consists mainly of acommunicating means, such as a modem 331, and a terminal unit 332. Themodem 331 communicates with the communicating means, such as the modem326. The terminal unit 332 communicates with the control apparatus 323via the modem 331 so as to reference information integrated by thecontrol apparatus 323 or input or edit information.

[0265] As shown in FIG. 20, the control apparatus 323 consists mainly ofa processor 351, a hard disk 352, a memory 353, a display control unit354, a printing control unit 355, a communication interface 356, a videosignal input/output circuit 357, and a communication interface 358. Theprocessor 351 controls the components of the control apparatus 323.Software programs to be run by the processor 351 and data, such as theendoscopic images and patient information, are stored in the hard disk352 and memory 353. A work area used by the processor 351 also ispreserved in the memory 353. The display control unit and produces avideo signal used to drive the display device 324. The printing controlunit 355 produces a video signal used to drive the printer 325. Thecommunication interface 356 helps transmit the patient information andsurgical apparatus information to or from the signal transmissionapparatus 321. The video signal input/output circuit 357 inputs to oroutputs from the signal transmission apparatus 321 video information,including endoscopic image data. The communication interface 358transmits information to the modem 326.

[0266] The processor 351 consists mainly of an information accumulationunit 351 a, a display information production unit 351 b, and a clinicalrecord production unit 351 c. The endoscopic image data, patientinformation, and surgical apparatus information, which are inputindependently via the signal transmission apparatus 321, are accumulatedin the information accumulation unit 351 a with the software programsstored in the hard disk 352 and memory 353. The display informationproduction unit 351 b edits information accumulated in the informationaccumulation unit 351 a, and produces screen information concerning ascreen display on the display device 324. The clinical record productionunit 351 c edits the accumulated information and produces a clinicalrecord to be output to the printer 325.

[0267] The video signal input/output circuit 357 consists mainly of anA/D converter 357 a, a D/A converter 357 b, a video signal encoderdecoder 357 c, and a controller 357 d. The A/D converter 357 a convertsan input analog video signal into a digital video signal. The D/Aconverter 357 b converts a digital video signal into an analog videosignal and outputs the analog video signal. The video signal encoderdecoder 357 c decodes a video signal input via the A/D converter 357 a,samples a desired endoscopic image signal from the input video signal,encodes a video signal to be output, and supplies the resultant signalto the D/A converter 357 b. The controller 357 d controls the videosignal encoder and decoder 357 c and other elements of the video signalinput/output circuit 357.

[0268] As shown in FIG. 21, an endoscopic image area 362, a thumbnailimage area 363, and a surgical apparatus information area 365 aredefined in an integrated information screen 361 displayed on the displaydevice 324 according to an output from the control apparatus 323.Endoscopic images are displayed in the endoscopic image area 362. Aplurality of thumbnail images, reduced images produced by thinningpixels that constitute endoscopic image data, is displayed in thethumbnail image area 363. Patient information is displayed in thepatient information area 364. Surgical apparatus information isdisplayed in the surgical apparatus information area 365.

[0269] As shown in FIG. 22, an endoscopic image area 372, a thumbnailimage area 373, and a patient information area 374 are defined in aclinical record 371 output from the printer 325 according to an outputfrom the control apparatus 323.

[0270] Operations executed by the present embodiment will be describedbelow.

[0271] A video signal containing endoscopic image data produced by theendoscope system 311 during endoscopic examination is transmitted to thesignal transmission apparatus 317. The signal transmission apparatus 317encodes the video signal and transmits it to the signal transmissionapparatus 321 over the communication line 304. The video signal receivedby the signal transmission apparatus 321 is converted into a digitalsignal by the A/D converter 357 a in the video signal input/outputcircuit 357 of the control apparatus 323, and then decoded by the videosignal encoder decoder 357 c.

[0272] If necessary, the video signal encoder decoder 357 c samplesdesired endoscopic image data contained in the video signal under thecontrol of the control unit 357 d controlled by the processor 351 Theendoscopic image data retrieved by the video signal input/output circuit357 are accumulated in the information accumulation unit 351 a.

[0273] Surgical apparatus information sent from the touch panel 315 andsurgical apparatus 313 to the control apparatus 314 is fed to the signaltransmission apparatus 317. The signal transmission apparatus 317transmits the surgical apparatus information to the signal transmissionapparatus 21 over the communication line 304. The surgical apparatusinformation received by the signal transmission apparatus 321 isretrieved into the control apparatus 323 via the communication interface356 and accumulated in the information accumulation unit 351 a.

[0274] Patient information supplied from the magnetic card reader 316 tothe control apparatus 314 is fed to the signal transmission apparatus317. The signal transmission apparatus 317 transmits the patientinformation to the signal transmission apparatus 321 over thecommunication line 304. The patient information received by the signaltransmission apparatus 321 is retrieved by the control apparatus 323 viathe communication interface 356 and accumulated in the informationaccumulation unit 351 a.

[0275] As mentioned above, information, such as endoscopic imageinformation, surgical apparatus information, and patient information,input from different apparatuses or developed on different occasions areaccumulated in the information accumulation unit 351 a in the controlapparatus 323.

[0276] Information accumulation in the information accumulation unit 351a is edited based on a screen display format by the display informationproduction unit 351 b. The integrated information screen 361 isdisplayed on the display device 325. Endoscopic image information,patient information, and surgical apparatus information input fromdifferent input units or developed on different occasions are integratedinto the integrated information screen 361. In the integratedinformation screen 361, if any thumbnail image is selected fromthumbnail images of endoscopic images displayed in the thumbnail imagearea 363, an endoscopic image associated with the selected thumbnailimage may be displayed in the endoscopic image area 362.

[0277] Information accumulated in the information accumulation unit 351a is edited based on a printout format by the clinical record productionunit 351 c. The printer 325 outputs a clinical record 371. Endoscopicimage information and patient information input from different inputunits or developed on different occasions are integrated into theclinical record 371.

[0278] Information accumulated in the control apparatus 323 istransmitted to the terminal unit 332 in the information referenceapparatus 303. The information is transmitted by way of the modem 326connected to the communication interface 358, the communication line 305linked to the modem 326, and the modem 331 in the information referenceapparatus 303. The terminal unit 332 uses, for example, a display devicethereof to display information contained in the integrated informationscreen 361 or clinical record 371 in an integrated manner. Theinformation reference apparatus 303 may be installed in a plurality ofsites. Information accumulated in the information accumulation system302 may therefore be referenced or, if necessary, edited at any site.

[0279] According to the present embodiment, medical treatmentinformation, such as endoscopic image information, surgical apparatusinformation, and patient information, that is input from different inputunits or develops on different occasions are accumulated in the controlapparatus 323. The control apparatus 323 causes the display device 324to display the integrated information screen 361 into which theaccumulated information is integrated and which contains clinical recordinformation. The control apparatus 323 also causes the printer 325 toprint out a clinical record. Consequently, the time required foracquiring and accumulating medical treatment information is reduced, andthe efficiency in producing a clinical record improves.

[0280] Not only endoscopic image information acquired by the endoscopesystem 311, but also information acquired by related instruments, suchas various types of surgical instruments 313, can be accumulated.

[0281] The magnetic card reader 316 is used to read patient information.The labor for entering patient information at a keyboard or the like istherefore eliminated.

[0282] Medical treatment information can be referenced or edited in anysite using the information reference apparatus 303.

[0283] Medical treatment information acquired by the operating roomsystem 301 installed in an operating room is accumulated in theinformation accumulation system 302 installed in a remote site, forexample, in another room. The medical treatment information cantherefore be edited in another room. Tasks related to surgery can beprocessed to thus provide support from a remote site other than theoperating room. If the information reference apparatus 303 is installedin the operating room, a clinical record produced with the supportprovided from the remote site can be referenced in the operating room.Consequently, work can be performed efficiently in the operating room.

[0284] The modems 326 and 331 may be replaced with any othercommunication units, for example, terminal adaptors. The hard disk 352may be replaced with any other storage means, for example, amagneto-optical disk.

[0285] The magnetic card reader 316 may be replaced with an apparatusfor reading information from a portable medium other than a magneticcard, such as an IC card or an optical card.

[0286] Although the present invention has been described in relation toparticular embodiments thereof, many other variations and modificationsand other uses will become apparent to those skilled in the art. It ispreferred, therefore, that the present invention be limited not by thespecific disclosure herein, but only by the appended claims.

What is claimed is:
 1. A remote surgery support system, comprising: anendoscopic imaging means, installed in an operating room, for imaging aregion, which undergoes surgery, using an endoscope inserted into apatient's body; a first control means for controlling said endoscopicimaging means and a surgical instrument used for surgery; an input meansfor use in inputting a control signal, with which said surgicalinstrument is controlled, to said first control means; a first signaltransmission apparatus for receiving said control signal, which is inputusing said input means, from said first control means, and convertingthe signal; a communication line over which a signal produced by saidfirst signal transmission apparatus is transmitted from said operatingroom to a control room in a remote place; a second signal transmissionapparatus for receiving a signal produced by said first signaltransmission apparatus over said transmission line, and converting thesignal into a signal corresponding to said signal that has not beenconverted by said first signal transmission apparatus; a second controlmeans for receiving said signal from said second signal transmissionapparatus; and a display device for displaying an output of said secondcontrol means.
 2. A remote surgery support system according to claim 1,further comprising a third signal transmission apparatus fortransmitting information to said second signal transmission apparatus,and a medical information accumulating means for accumulatinginformation transmitted from said first and third signal transmissionapparatuses to said second signal transmission apparatus with relevantinformation items associated with one another.
 3. A remote surgerysupport system according to claim 1, wherein: said endoscopic imagingmeans, surgical instrument, and input means are installed in saidoperating room; and said information accumulating means for accumulatinginformation sent from a plurality of apparatuses, including saidendoscopic imaging means, surgical instrument, and input means, and aclinical record editing means, for editing information accumulated insaid information accumulating means so as to produce clinical recordinformation concerning said patient, are installed in said control room.